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The Myth of Drug Expiration Dates (propublica.org)

schwit1 shares a report from ProPublica: Hospitals and pharmacies are required to toss expired drugs, no matter how expensive or vital. Meanwhile the FDA has long known that many remain safe and potent for years longer. The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates -- possibly toxic, probably worthless. But to Lee Cantrell, who helps run the California Poison Control System, the cache was an opportunity to answer an enduring question about the actual shelf life of drugs: Could these drugs from the bell-bottom era still be potent?

Gerona and Cantrell, a pharmacist and toxicologist, knew that the term "expiration date" was a misnomer. The dates on drug labels are simply the point up to which the Food and Drug Administration and pharmaceutical companies guarantee their effectiveness, typically at two or three years. But the dates don't necessarily mean they're ineffective immediately after they "expire" -- just that there's no incentive for drugmakers to study whether they could still be usable.

Tests on the decades-old drugs including antihistamines, pain relievers and stimulants. All the drugs tested were in their original sealed containers. The findings surprised both researchers: A dozen of the 14 compounds were still as potent as they were when they were manufactured, some at almost 100 percent of their labeled concentrations. Experts say the United States might be squandering a quarter of the money spent on health care. That's an estimated $765 billion a year.

14 of 316 comments (clear)

  1. so frustrating would it be by Anonymous Coward · · Score: 0, Insightful

    If your drugs expired and you had to pay more money for more drugs. So frustrating would that be! Speaking of which, where's my money? Have my money by tomorrow and there, well you know, won't be any unfortunate problems, frustrating ones. Don't forget about my money!!!

  2. This is the sort of testing the Feds should do. by Anonymous Coward · · Score: 5, Insightful

    The manufacturers have zero incentive to do these sorts of tests, and private individuals have no way to force the expiration dates to be changed, so this is exactly the sort of testing that the FDA should be funding.

    But a more interesting question than the fact that several of the medications were at near 100% effectiveness, how many medications were actively harmful (as opposed to just less effective)?

    1. Re:This is the sort of testing the Feds should do. by darkain · · Score: 5, Insightful

      Sometimes I wish Slashdot had the ability to pin comments right to the top of the entire thread. This is probably the most useful piece of information I've read on any post at all today. Thanks for the info!

    2. Re:This is the sort of testing the Feds should do. by DarkOx · · Score: 2, Insightful

      Seriously, this is why we have such serious problems in this country today! You are laying a problem at the hands of capitalism, which is actually entirely created by government! Let me guess you solution is going to be more regulations too.

      Lets break this day.

      FDA (government) say to drug makers you need to set expiration dates. They say okay well we know they will be good for three years our packaging technology and stabilizers are at least that good. Safe bet for us, because...

      FDA (government) tells Hospitals/pharmacies/individuals they must toss out any expired drugs. So the drug makers don't need to worry about anyone actually determining these things can be used long past the manufacture guarantee, or worse that one of their competitors has better packaging / a more stable drug that they might choose for its long shelf life.

      Still more context government F'ed over the market place by creating the perverse nonsense of employers buying you health insurance. When they created complex rules around taxable income. Think about this, does your employer offer you auto insurance as a benefit, or a homeowners/renters policy, NO! literally no employees do that, why is that? Because health insurance got setup as a way for company to pay people more without incurring additional employment or income taxes. Similar tax breaks don't exist for other kinds of insurance so you don't seem them as part of employment compensation packages. 45 years later Democrats come along and offer this terrible sob story about how so many people lose coverage because the lose or change a jobs, and government has to do something about; a problem created entirely by bad government policy in the first place.

      So half the population does not really feel what they are paying for insurance because half of it is the employer contribution and they don't ever have to directly write those checks. Than insurers actually pay their medical bills so they don't feel writing those checks either. Consequence 80% of the participants in medical care don't have any clear perspective or care about what things actually cost! So nobody bothers to figure out if we are tossing good drugs into the landfill. All thanks to big government interference in the market place!

      Seriously there is a STUPID simple fix to the healthcare problems we are facing! 1) Repeal Obamacare. 2) Ensure medicaid is available and adequately funded to help the people who really are below the poverty line and can't afford any kind of even catastrophic coverage. 3) Withdraw the corporate tax incentives to offer medical coverage, this will mean all the HR time associated with that is pure overhead and will discourage them from doing so. 3a) Allow individuals to deduct medical coverage from income taxes but ONLY if they pay them directly, not if they are done as payroll deduction, this make employees not want corporate heal benefits. Now this is actually government interference but its to counter decades of expectations and should have an expiration date, maybe ten years, after which you would be allow to deduct anything done as a payroll deduction as well. 4) Allow people to choose "inferior" care, relax rules that require physicians to perform certain procedures and issue a range of prescriptions, so patients can choose facilities where nurse practitioners and other less expensive resources can do these. 5) Reduce regulations on drugs and drug manufacture, not eliminate mind you just roll back the number of inspections, identifying the most expensive regulations to comply with that are offering the least benefit in terms of safety. Torts will take care of the rest.

      Let the market work. This will result in enough price consciousness to actually lower prices, and creates opportunities to lower real costs. A strong individual insurance market would reemerge.

      --
      Repeal the 17th Amendment TODAY! Also Please Read http://www.gnu.org/philosophy/right-to-read.html
    3. Re:This is the sort of testing the Feds should do. by gumbi+west · · Score: 4, Insightful

      The problem with pre-existing conditions is actually that they are expensive to cover. So, if you do find a way to cover them it involves other people paying for them somehow. If it is other people who are healthy directly paying for them, some of them will realize that the healthcare is not worth the cost--they're literally paying for a benefit they don't get--insurance for chronic conditions. Then folks will drop out, that will raise rates even more... that's death spiral.

      The only way to deal with chronic conditions is to require only rich people to have them or for the government to pay for them.

    4. Re:This is the sort of testing the Feds should do. by jedidiah · · Score: 1, Insightful

      > Medicare for everybody. Universal Healthcare.

      You just contradicted yourself there. You seem only capable of repeating campaign slogans and know NOTHING of what you're actually talking about.

      We already have a mini-NHS. It's called the VA and it's a disgrace. Medicare isn't that hot either. Medicaid is just horrible. If you've got something really interesting going on, you're SOL under Medicaid.

      Your communist nonsense doesn't alter the fact that the US develops most of the new techniques, technologies, and drugs. When people want the best, the come to America. They don't go to some socialist utopia.

      My _city_ (and probably yours) has more and better medical treatment facilities than the majority of socialist countries (big or small).

      I really would rather that "good intentioned" morons like you destroy what we have and the world class treatment centers that are in your city and mine.

      Some of us need more from the medical establishment than treatment for the occasional hang nail.

      --
      A Pirate and a Puritan look the same on a balance sheet.
    5. Re:This is the sort of testing the Feds should do. by chaotixx · · Score: 3, Insightful

      If our current system is the best in the world, why are our health outcomes worse than many of the "socialist utopias" and more expensive to boot? Even if we agree that we have the best, newest treatments available for the rich people who can afford it, it doesn't do the masses any good if they can't afford access.

  3. Inventory Management Much? by TechyImmigrant · · Score: 4, Insightful

    If the expiration dates are 2-3 years from the date of manufacture, presumably pharmacies could do a little better inventory management and not have to throw any out. 2 years warning is plenty. Just keep 1 year's supply on hand. If demand drops, don't buy any more until you need to.

    --
    I should use this sig to advertise my book ISBN-13 : 978-1501515132.
    1. Re:Inventory Management Much? by Dan+East · · Score: 5, Insightful

      There are many drugs kept only for emergencies, in settings that have few emergencies, that must be thrown out and replaced when they expire. A good example is a general practitioner's office. They will keep a defibrillator, epinephrine, atropine, D50W, etc for medical emergencies, and may never use them over the course of a decade or two.

      Another example is the now infamous EpiPen. People that have severe allergic reactions must keep them on hand to ward off anaphylaxis, but they are usually so diligent about avoiding their allergens that they never need them. Thus they expire before they are used.

      Think of all the times patients are prescribed a medication but they cannot finish taking them (there are side affects, or the medicine isn't effective so another med is prescribed, etc, etc) and there are full pill bottles sitting around that could be used to treat other family members when they become ill. That would be.... efficient, would it not?

      --
      Better known as 318230.
    2. Re:Inventory Management Much? by DutchUncle · · Score: 4, Insightful

      There are many drugs kept only for emergencies, in settings that have few emergencies, that must be thrown out and replaced when they expire. A good example is a general practitioner's office. They will keep a defibrillator, epinephrine, atropine, D50W, etc for medical emergencies, and may never use them over the course of a decade or two.

      This category calls for more active management (which would never work in our real world because it would require cooperation and security). Each doctor's office small supply of these drugs could sit on the shelf for, say, half of their useful life, and then be transferred to the ambulance squad which will go through them before they expire. Instead the ambulance squad buys its own, and the office supply is wasted, for a net waste of money and supplies, because the transfer would count as an unlicensed re-sale or is prohibited (rather than treating it as an inter-pharmacy transfer or whatever the law calls it).

  4. Original sealed container by Anonymous Coward · · Score: 5, Insightful

    Most patients don't get their prescription pills in the original sealed container of hundreds of tablets or capsules that is shipped to the pharmacy, but in a non-sealed container that is subject to high humidity and large temperature variation when stored at home. So the at-home longevity is less, although still almost always at least a couple years longer than marked on the retail vial.

  5. Re:So to solve the health care crisis... by Phics · · Score: 4, Insightful

    I'm pretty sure that this experiment didn't set out to prove the FDA is corrupt and is maliciously slapping arbitrary expiry dates on drugs so you would waste your money. The FDA's primary goal isn't drug stability over 15 years, for example, it's what is safe in a reasonable amount of time for those drugs to be consumed. Do you really want to pay the FDA to do decades long studies on all prescription drugs with the intent of seeing how many generations you can pass your prescription drugs cache down?

    --
    There are two types of people in the world; those who believe there are two types of people, and those who don't.
  6. Re:The US is wealthy by Anonymous Coward · · Score: 3, Insightful

    Countries more wealthy than the US and those of a similar level of wealth also tend to generate a lot less waste. There is a certain cultural element to the US being very wasteful compared to other countries.

    That being said, erring on the side of caution with medicine (and thus being wasteful) is common throughout the developed world. Drug expiry dates will always remain based on pessimistic expectations and the manufacturer has no incentive to invest in studies that could show whether those expectations may be too pessimistic. It would be good if governments, hospitals and/or health insurance companies would make arrangements to reduce waste were possible. Being cautious is good, throwing away large amounts of perfectly fine medicine made using precious resources is not.

  7. Re:FDA Stability Requirements by gmack · · Score: 3, Insightful

    OK, I think I'm not being clear. I agree completely and that's why my original post stated "potentially disastrous results"

    The study I posted said that expired Epipens are more likely to provide a reduced dose but should be used anyway if there is no other option since a reduced dose is better than no dose and the Epipen won't poison you. IE the best of the worst options.

    For that, I got 2 replies (not going to count the AC) and a downmod from people who fail at reading comprehension who took the study to mean that expired Epipens are just fine, when the study said no such thing.